Healthcare Provider Details

I. General information

NPI: 1952806853
Provider Name (Legal Business Name): DIANA XINYUE LU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 US HIGHWAY 287
BROOMFIELD CO
80020-7021
US

IV. Provider business mailing address

1190 US HIGHWAY 287
BROOMFIELD CO
80020-7021
US

V. Phone/Fax

Practice location:
  • Phone: 303-544-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0076749
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number009136
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: